Abstract: Hepatocellular carcinoma (HCC) is one of the most common cancer worldwide that causes death and in Egypt the burden of HCC is increasing. Prognosis depends on tumor stage. Insulin-like growth factors (IGFs) play an important role in cancer risk. IGF-II is a polypeptide involved in the proliferation and differentiation of normal, transformed and malignant hepatocyte. It is anticipated that HCC may produce IGFII, and serum IGF-II level may increase in patients with HCC so can be used as a serological test for the diagnosis of HCC. The aim was to assess the value of serum IGF-II in Egyptian patients with HCC. This study was included 40 patients with HCC, 30 patients with liver cirrhosis and 18 healthy controls. For all groups we studied clinical data, image findings, serum alpha fetoprotein(AFP) levels detected by enzyme immunoassay(EIA) kit and IGF-II serum levels were quantified using ELIZA technique. Tumor imaging characteristics of HCC including size, number and site were assessed. Tumor staging was done using Okuda ,Tokyo staging systems,CLIP and VISUM. The results showed that IGF-II values were higher in HCC cases than cirrhotics (P1=